1981, 12-01 Permit G81B-2283 Temp Gas Htr(PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
4611 txc (Afri. ethz5e ateriz7kr
LOT BLOCK
3.
WNER
SUBDIVISION r1__
PHONE
ADDRESS
ZIP
4.
CONTRACTOR
PHONE
ADDRESS
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
TO
ZIP97.0
PHONE
ZIP
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER'S
Actual Set Backs in Feet
North
South
East
West
Size of Parcel
Type Const.
Valuation
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Main Floor Upper Floors Garage Area
Area of Decks
Storage
Finished Basement Unfin. Basement
TYPE
7. OF
WORK
NEW 0 ALT. ❑ A9,N. ❑ RPL. ❑ MVE.
0 BLO. ❑ PLMB. ISPMECH. ❑ M.H. 0 POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms INo. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd. Rec'd. Not Req'd.
DESCRIBE WORK Jj 's/
VAL AT
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
Enum. Dist. I Location (Area)
Ownership
Public ❑ Private 0
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS J'
DATE OF APPLICATION /s01' / — gr/ir
r
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
FEES COLLECTED
Single
Building
umbing
ech. /I
Plan Check
SEPA
Mobile Home
Other (Specify)
$
TOTAL $ 12___
04* *1,a00
*1800
*18006
A *000 U
22822
12-01-81
z 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
12--01-81 228.)z *18.002[2
DATE ISSUED
PERMIT NO. TOTAL